28D2093636 CLIA NUMBER - KOHLL'S RX STORE 3 WAGEY'S

Laboratory Demographics

  • CLIA Code: 28D2093636
  • Facility Name: KOHLL'S RX STORE 3 WAGEY'S
  • Facility Address: 808 NORTH 27TH STREET
    LINCOLN, NE
    ZIP 68503
  • Facility Phone: 402 973-1914
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: DENISE R. WHITE
  • NPI Number: 1629543665
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2093636
LAB Type Independent
Facility Name KOHLL'S RX STORE 3 WAGEY'S
Street 808 NORTH 27TH STREET
City LINCOLN
State NE
ZIP 68503
Phone 402 973-1914
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Independent
Lab Director DENISE R. WHITE

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This page was last updated on: 9/29/2025